PND27 ECONOMIC BURDEN OF PROBABLE LENNOX-GASTAUT SYNDROME, PROBABLE DRAVET SYNDROME, AND OTHER REFRACTORY EPILEPSIES FOR UNITED STATES COMMERCIAL HEALTH PLANS

Abstract

Previous studies of healthcare costs for patients with Lennox-Gastaut syndrome (LGS) and Dravet syndrome (DS) were conducted before or shortly after the availability of newer antiepileptic drugs (AEDs). This study updates previous analyses of the direct cost burden of probable LGS, probable DS, and other refractory epilepsies using more recent data from US commercial health plans. Using the IBM® MarketScan® Commercial database, continuously-enrolled patients were identified if they had ≥1 AED claim and medical claims with ≥1 diagnosis code for LGS or refractory epilepsy or ≥1 claim for clobazam or rufinamide between 10/1/2015 and 03/31/2016. A previously-developed algorithm was used to stratify patients into 3 cohorts: probable LGS, probable DS, or other refractory epilepsies. All-cause and epilepsy-related healthcare costs were measured over the 12-month post-index period following each patient’s earliest diagnosis or AED claim (index date). Of 8,196 patients identified, 1,296 were classified as probable LGS, 183 as probable DS, and 6,717 as other refractory epilepsies. Patients with probable LGS or DS were younger than patients with other refractory epilepsies (mean 16.5, 14.5, and 33.5 years, respectively). Number of distinct AEDs during the 12-month pre-index period averaged 3.4, 2.6, and 2.1, respectively. Mean all-cause total healthcare costs were highest for probable LGS ($80,545), followed by probable DS ($77,914), and other refractory epilepsies ($43,794). All-cause medical costs averaged $56,527, $63,850, and $32,403, respectively. The majority of medical costs were epilepsy-related (71.2%, 80.5%, and 62.5%, respectively). Total pharmacy costs averaged $24,018, $14,064, and $11,391 respectively. The majority of pharmacy costs were for AEDs (72.6%, 70.8%, 65.8%, respectively). Results highlight the substantial direct cost burden of probable LGS, probable DS, and other refractory epilepsies for US commercial plans. Total healthcare costs for probable LGS or DS were higher than earlier analyses, with higher per-patient AED costs a contributing factor.